For the Consumer

In addition to its needed effects, some unwanted effects may be caused by betaxolol ophthalmic (the active ingredient contained in Betoptic S). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking betaxolol ophthalmic:

More common

Pain in the eye

Rare

Blistering, peeling, or loosening of skin

blue lips, fingernails, or skin

blurred vision

change in color vision

chest pain or discomfort

chills

cough

crusting of eyelashes

decreased urine output

decreased vision

diarrhea

different size pupils of the eyes

difficulty in breathing, chewing, swallowing, or talking

difficulty seeing at night

dilated neck veins

double vision

drainage from eyes

drooping eyelids

extreme fatigue

fast, slow, or irregular heartbeat

feeling of having something in the eye

hives

increased sensitivity of eyes to sunlight

irregular, fast or slow, or shallow breathing

irritation or inflammation of eye

itching, dryness of eyes

itching skin

joint or muscle pain

lightheadedness, dizziness, or fainting

muscle weakness

noisy breathing

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

severe tiredness

shortness of breath

skin rash

sore throat

sores, ulcers, or white spots in mouth or on lips

sweating

swelling of eyelids

swelling of face, fingers, feet, or lower legs

tearing

thickened mucous from lungs

tightness in chest

troubled breathing

unusual tiredness or weakness

weight gain

wheezing

Some of the side effects that can occur with betaxolol ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

For Healthcare Professionals

General

Although systemic adverse events are infrequently reported, topically applied betaxolol ophthalmic (the active ingredient contained in Betoptic S) drops may be absorbed systemically and side effects similar to systemically administered betaxolol or other beta-blockers such as severe respiratory or cardiac reactions may be experienced.[Ref]

Ocular

Ocular side effects have frequently included transient ocular discomfort and ocular irritation in up to 25% of patients. Blurred vision, corneal punctate keratitis, foreign body sensation, photophobia, tearing, itching, dryness of eyes, erythema, inflammation, discharge, ocular pain, decreased visual acuity, crusty lashes, noninfectious dendritic epithelial keratitis, anisocoria, photophobia, and anterior uveitis have been reported rarely. A smaller number of patients with glaucoma may have corneal sensitivity to betaxolol. In addition, choroidal detachment has been reported after filtration procedures and cases of bacterial keratitis have been reported as a result of inadvertent contamination by patients.[Ref]

Betaxolol has caused histamine release from human leukocytes, which may account for its irritant effects.[Ref]

Cardiovascular

An 81-year-old man with a history of hypertension and glaucoma suffered an acute myocardial infarction within five minutes after a single drop of betaxolol 0.5% ophthalmic solution. The author believes that betaxolol may have allowed alpha-mediated coronary artery vasospasm, although severe hypotension or an arrhythmia could not be ruled out. Carotid sinus syncope was considered as a result of hyperextension of the patient's neck while using the eyedrops, but was thought to be unlikely since the syncope occurred minutes later.[Ref]

Cardiovascular side effects have included bradycardia, heart block and congestive failure. It should be noted that death due to cardiac failure has been reported following use of topical beta-blockers.

One case of myocardial infarction has been associated with betaxolol.[Ref]

Respiratory

Respiratory side effects are related to the ability of betaxolol to inhibit bronchodilation, which may be important in some patients with reversible airway disease, including asthma or severe obstructive lung disease.

A 74-year-old woman with a subarachnoid hemorrhage developed acute pulmonary edema and wheezing after betaxolol eyedrops and intravenous labetalol were administered for open angle glaucoma and hypertension. Congestive heart failure and hypervolemia were ruled out by hemodynamic measurements. The authors of this case report diagnosed acute bronchospasm based on the clinical picture and low cardiac filling pressures. The patient had never smoked, had no personal or family history of asthma, ruled out for myocardial infarction, developed no new ECG findings, and had no recurrent wheezing or hypoxemia when captopril was substituted for labetalol and betaxolol was discontinued.[Ref]

Nervous system

Nervous system side effects have included nightmares, insomnia, dizziness, vertigo, headache, depression, lethargy, and increases in the signs and symptoms of myasthenia gravis.[Ref]

A 75-year-old man experienced chronic and frightening nightmares associated with betaxolol eyedrops, which were alleviated after he shut his eyes tightly after administration. By doing so, the lacrimal ducts were occluded, which is thought to significantly decrease the systemic absorption of the eyedrops.[Ref]

Gastrointestinal

Gastrointestinal side effects have rarely included general gastrointestinal disturbances, such as diarrhea or nausea.[Ref]

Hypersensitivity

Hypersensitivity side effects have included dermatitis, hives, and toxic epidermal necrolysis.[Ref]

Professional resources

Other formulations

Related treatment guides

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